President, CarePartners of Connecticut
Company: Tufts Health Plan
Posted on: January 17, 2020
KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS
Develop the vision and strategies for establishing, differentiating
and growing CPCT to be a market leading Medicare Advantage plan.
Collaborate with THP leaders in marketing, product, network
management, risk adjustment, population health, operations and
quality to develop plans to meet annual and long term growth and
performance goals for membership growth, financial performance, and
quality and member satisfaction.
Responsible for direct reports to include the in-market sales and
growth team as well as the CPCT Medical Director. Matrixed
relationships with market staff to include: network contracting,
provider performance management, care management, THP leaders of
shared services to CPCT including: Marketing, Sales Support,
Product Strategy, Risk Adjustment. Population Health, Operations,
Compliance, Actuarial and Finance
Build, maintain and utilize strong matrix relationships with THP
leaders in all key functions to develop and oversee execution of
plans to achieve performance targets.
Develop and manage the execution of sales strategies, plans and
activities that drive membership growth/market share. Lead the
in-market sales function to achieve sales goals through broker and
direct sales activities. Collaborate with THP sales leadership to
ensure effective sales support and alignment of activities to meet
Define objectives for marketing and promotion to establish the CPCT
brand, promote the plan, and generate leads to support the
achievement of growth targets. Collaborate with THP marketing
leadership to develop and implement multi-channel marketing plans
including digital, mass media, community and provider.
Define product strategies to enable membership growth and earnings
performance. Collaborate with THP leadership to assess, develop and
implement new or refined products, plans, and services. Collaborate
with THP leaders in product and actuarial to develop the annual CMS
bids ensuring products are competitive, differentiated and support
the achievement of membership and earnings goals.
Direct and collaborate with the CPCT Medical Director to define the
strategies needed to meet medical cost targets, manage utilization
and produce high quality outcomes. Collaborate with THP healthcare
services leaders, Hartford HealthCare clinical leaders and other
providers to develop and implement plans to effectively manage
care, cost and quality.
Define the overall strategy for the provider network to enable
membership growth and deliver high quality cost effective care.
Define objectives for contract structures, payment methods and
incentives. Collaborate with THP network contracting and
performance management leadership to develop contracts and networks
and maintain and manage network performance.
Define objectives for the management of CMS risk adjusted revenue,
operations and quality. Collaborate with THP leadership in these
functions to develop, implement and oversee plans to meet
Collaborate with THP compliance to ensure plan compliance with CMS
regulations. Oversee in- market sales and broker performance to
meet CMS regulations.
Oversee health plan financial performance and collaborate with CPCT
and THP leaders to devise and implement plans to improve results to
meet targets. Develop and manage the annual financial plan and
annual administrative expense budget to meet operating performance
Represent CPCT with the public and with local groups and
associations. Develop and nurture relationships with key external
stakeholders including; providers, regulators, community
influencers, brokers and employers.
Oversee financial, quality, medical cost and operational
performance and report results to Board of Directors. Collaborate
with HHC and THP leaders to identify and address service, support
and operational performance issues
* Bachelor's degree required. Master's degree in business, health
administration, or a related field preferred
* 15+ years of health plan leadership experience, including
extensive experience specific to Medicare Advantage.
* A history of business ownership roles and a track record for
meeting financial and business goals. Prior P&L
* Experience establishing and growing a health plan. Understands
sales and marketing in a direct to consumer health plan and can
leverage to develop strategies to grow membership
SKILL REQUIREMENTS: (Include interpersonal skills)
* Ability to lead and influence across functions in a highly
matrixed organization. Savvy about managing competing interests and
priorities in a shared services environment.
* Leadership presence and style that inspires confidence, builds
and maintains successful working relationships and motivates
others. Credible market facing leader with well-developed
WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS:
* The president will spend the majority of time in the Connecticut
market. Frequent travel around the state of Connecticut will be
CONFIDENTIAL DATA: All information (written, verbal, electronic,
etc.) that an employee encounters while working at Tufts Health
Plan is considered confidential. Exposed to and required to deal
with highly confidential and sensitive material and must adhere to
corporate compliance policy, department guidelines/policies and all
applicable laws and regulations at all times.
What we build together changes our customer's health for the
better. We are looking for talented and innovative people to join
our team. Come join us!
Tufts Health Plan is an equal opportunity employer. Qualified
applicants will receive consideration for employment without regard
to race, color, religion, sex, sexual orientation, gender identity,
national origin, disability or protected veteran status. For our
EEO Policy Statement, please click here. If you d like more
information on your EEO rights under the law, please click here.
Keywords: Tufts Health Plan, New England , President, CarePartners of Connecticut, Executive , Wethersfield, Northeast
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